Repository logo
 

The PRECISE Recommendations for Prostate MRI in Patients on Active Surveillance for Prostate Cancer: A Critical Review.

Accepted version
Peer-reviewed

No Thumbnail Available

Type

Article

Change log

Authors

Sanmugalingam, Nimalan 
Sushentsev, Nikita 
Lee, Kang-Lung 
Caglic, Iztok 
Englman, Cameron 

Abstract

The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations were published in 2016 to standardize the reporting of MRI examinations performed to assess for disease progression in patients on active surveillance for prostate cancer. Although a limited number of studies have reported outcomes from use of PRECISE in clinical practice, the available studies have demonstrated PRECISE to have high pooled NPV but low pooled PPV for predicting progression. Our experience in using PRECISE in clinical practice at two teaching hospitals has highlighted issues with its application and areas requiring clarification. This Clinical Perspective critically appraises PRECISE on the basis of this experience, focusing on the system's key advantages and disadvantages and exploring potential changes to improve the system's utility. These changes include consideration of image quality when applying PRECISE scoring, incorporation of quantitative thresholds for disease progression, adoption of a PRECISE 3F sub-category for progression not qualifying as substantial, and comparisons with both the baseline and most recent prior examinations. Items requiring clarification include derivation of a patient-level score in patients with multiple lesions, intended application of PRECISE score 5 (i.e., if requiring development of disease that is no longer organ-confined), and categorization of new lesions in patients with prior MRI-invisible disease.

Description

Keywords

PRECISE guidelines, active surveillance, cancer, prostate MRI

Journal Title

AJR Am J Roentgenol

Conference Name

Journal ISSN

0361-803X
1546-3141

Volume Title

Publisher

American Roentgen Ray Society